AYURVEDIC INSIGHTS AND CLINICAL MANAGEMENT OF PAKSHAGHATA SECONDARY TO CEREBROVASCULAR ACCIDENT DUE TO ARTERIOVENOUS MALFORMATION (AVM): A CASE STUDY

Introduction: Pakshaghata is one among the vatavyadhi caused by prakupita vata, where prakruta vata governs the nervous function and movement in the body. Pakshaghata clinically correlates with hemiplegia - a neurological deficit characterized by paralysis on one side of the body. This may arise due to cerebrovascular accident, which may be either due to an ischemic or haemorrhagic event. The crude prevalence of stroke in India ranges from 44.29 to 559 per 100,000 people. This case study presents a paradigm of an Ayurvedic management in the treatment of Pakshaghata. Method: A 30-year-old female patient presented with the chief complains of weakness, heaviness over the left half of the body, difficulty in walking and slurred speech persisting for the past 2 years. She was previously (2years ago) diagnosed with Ruptured right temporal Arteriovenous Malformation (AVM) Spetzler martin grade 1. Patient underwent right Fronto-temporo-parietal (FTP) decompressive craniectomy and evaluation of hematoma with augmentative duroplasty followed by re exploration and excision of AVM. To address her current complaints, patient was treated with panchakarma procedure, shamana ousadhi and physiotherapy. Result: Patient showed significant improvement in terms of motor function especially muscle strength of the body and also showed clarity in speech after the treatment. Discussion: In the present case, the initial phase of treatment focused on treatment of avarana, followed by treatment measures to address dhatukshaya which results in balancing vata dosha. Treatment was not only aimed at balancing the vitiated vata dosha but also to improve the overall quality of life.